[Excerpted from an article by Carol Hardy in our Spring 2015 Newsletter.]

The following procedure can be used in case of an “expected” death where the person was known to have a terminal condition.
First, ascertain that the person has died. Check for a pulse and signs of breathing, and note whether the body is still warm. If you are certain that the person is dead, sit down and consider what to do next. An expected death is not an emergency. You need not to do anything right away. If you wish, sit with the deceased person and reflect on times shared. Do you want to call a friend or family member to be with you? This may be the last quiet time you will have with the deceased person before medical and funeral protocols begin. When you are ready, call the appropriate agency. 

Whom should you call? What information do you need to have available?
There are only two choices of whom to call. If the deceased was served by a hospice (Hospicare in Tompkins County), call the hospice. A person with appropriate authority will come, pronounce the death, and put funeral plans into motion.

If the deceased was not with hospice, then prepare to call 911.
You will need to have some information ready.

  1. Did the deceased have an Out-of-Hospital DNR order or a MOLST form? If so, find it and have it on hand. [Note: It is important to have the DNR on hand if you call 911. Otherwise, when the EMTs arrive they will attempt to resuscitate a body that is still warm, even if there is no pulse or breathing. A MOLST form (Medical Orders for Life-Sustaining Treatment) also has legal force at home, but a living will or health care proxy is NOT valid in a home setting.]
  2. What is the name of the deceased’s physician, and what funeral home or cremation service is to be called? If you do not know which funeral home or cremation service to use, the body will be taken to the morgue and picked up there by the funeral home after one is chosen.
  3. Find and be able to present either a list of the person's medications or the prescription containers.
  4. Make the 911 call, but tell the 911 operator that the person has died, that the death was expected, and that no emergency exists.
  5. Present the DNR to the EMTs when they arrive. They will ascertain that the person has died and will contact the funeral home.
  6. Be prepared to deal with law-enforcement people. Even if the death was expected and you were present,it will be considered “unattended” unless hospice was involved or a physician was present. The police or sheriff's deputies will come to investigate.

You can talk with the funeral director about when the body is to be picked up if you want more time with the deceased or if family members and friends want to say goodbye before the body is taken away; removal need not be immediate. This may be important to the survivors. A hospice worker or the funeral director can advise the family on temporary after-death care of the body in the home.

The procedure for unexpected deaths at home is different: you should call 911 immediately.
Unexpected deaths include the death of a person "too young" or who is not known to have any terminal condition. They also include deaths resulting from accidents or foul play or suicide. EMTs will come and attempt resuscitation. If that fails, police or sheriff's deputies will come to investigate the death. It is important to try to find the medications the deceased was taking, as the police may want this information. If you do not have legal authority for the funeral decisions, call a member of the deceased person's family immediately. You or a responsible relative of the deceased will be asked to give the name of the chosen funeral home or cremation service. Later the person with authority will convey decisions about funeral arrangements.

Then you will need to notify other relatives and friends. Here again, there is no immediate rush. If it is dinnertime, wait until after dinner to call; if it is night, wait until morning.

The foregoing information points to the need for preplanning, for both end-of-life issues and funeral arrangements. Even with preplanning, death of a loved one is distressing, but planning ahead does help.